Urban communities shun TB screening

THE Tuberculosis (TB) Control Manager in the Ministry of Health, Llang Maama, says the public must change its behaviour towards the ongoing programme to screen people for the disease if the country to win its battle against the disease.

Dr Maama said this in a recent interview with the Lesotho Times while giving an update on the ministry’s National TB Prevalence Survey which started in February and ends in August 2019. The survey is targeting 26 000 people country wide and aims at determining the actual number of people infected with TB country wide.

Lesotho has in the past relied on the World Health Organisation (WHO) global TB report whose estimates are taken from the number of patients seen or put on treatment hence the government through the ministry embarked on a survey. The figures place Lesotho in the first place ahead of South Africa among the world’s 30 most TB burdened countries.

According to the 2018 WHO Global TB Report Lesotho is first with 655 TB cases for every 100 000 people.

However, Dr Maama said while her ministry has seen progress with the survey, there is still a challenge of lack of behavioural change which she hopes can be influenced positively by advocacy strategies.

Dr Maama said although it was too early to tell the impact of the negative attitude towards TB screening on the survey, if it were to persist, the survey results would be distorted.

She said such challenges are particularly high in urban areas where people shun services provided by mobile clinics which are responsible for the TB screening in the 54 clusters “because they feel they can easily access clinics whenever they fall ill”.

“It is too early to tell the impact but if it (negative attitude towards screening) persists, it could render the survey irrelevant because the residents say they already have access to all medical facilities so they do not feel the need to screen,” Dr Maama said.

“I remember one person saying they can always go to the doctor whenever they fall sick.”

Dr Maama also said some people develop cold feet at the last minute due to fear on the unknown.

She said during their progress tracking exercise, they noted high non-responsiveness in Naleli, in Maseru as most participants did not turn up for the screening despite being invited in door-to-door visits.

“We do house-to-house visits to invite people for screening and they accept but they do not honour the invitations. They can say they will come but they never do and this may end up distorting the results.

“Generally, the survey has faced these challenges in areas that are close to towns, so good advocacy is needed,” she said.

She also added that they also face challenges with hard to reach areas where the terrain is mountainous and cannot be reached with mobile clinics.

Dr Maama said there was also poor participation in screening by males aged 25 to 45 years.

“It is worrisome since according to current data, they are mostly affected age groups because miners and ex-miners fall into this category,” Dr Maama said.

She said they have so far covered 11 clusters out of the targeted 54.

Dr Maama said despite the challenges they are encountering, they pride themselves for taking the initiative.

She also said realising the challenges at an early stage has helped them rectify some problems as they progress with the survey.

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